颅内血管外皮细胞瘤CT和MRI影像分析及治疗选择

Analysis of CT and MRI Features and Treatment Options of Intracranial Hemangiopericytoma

目的:分析颅内血管外皮细胞瘤(HPC)的CT及MRI表现,提高对本病的认识,以便合理选择治疗方案方法:对经CT和MRI检查并经手术病理证实为HPC的5例患者进行分析。5例均行MRI平扫及增强扫描;5例CT行平扫,3例增强。结果:5例CT平扫为等高密度肿块,占位效应明显,无明显瘤周水肿。MRI扫描T1WI呈等低不均匀信号,T2WI呈不均匀等高信号,显示血管流空,增强后病灶均明显强化,4例不均匀,1例均匀强化,2例示脑膜尾征。结论颅内血管外皮细胞瘤具有一定的CT、MRI特征性表现:呈分叶状与脑膜相连,丰富的血管流空,血管周围围管性浓染,肿瘤内密度或信号常不均匀,无明显肿瘤内钙化,可见颅骨局限性骨吸收。HPC首选手术治疗,完整切除肿瘤,术后辅以放射治疗。

Objective:To study the CT and MRI features of intracranial hemangiopericytomas (HPC) and to make a further understanding and suggest right treatment plan.Methods:5 cases of intracranial hemangiopericytomas were proved by pathology.All patients underwent MRI,CE MRI and CT.3 of them underwent CECT.Results:On plain CT scans,5 cases appeared hyperdense,marked mass effect and no peritumoral edema.MRI findings were heterogeneous iso- or hypo-intensity on T1WI and heterogeneous iso- or hyper-intensity on T2WI.Lesions showed flow void and marked homogeneous enhancement.2 cases had a “dural tail” sign.Conclusion:Intracranial hemangiopericytoma has special CT and MRI features:multilobulated,rich in vascular flow void in the tumor,heterogeneous density or signal intensity on CT or MRI,no hyperostosis and intratumoral calcification.HPC should be treated by surgery firstly,and supplemented with radiotherapy.